Effect of Tobacco and Betel Nut on Periodontal Health in Diabetics
Abstract
Jebun Nessa, Md Obaidur R Chowdhury and Atiquzzaman Khan
A hospital-based cross-sectional study was undertaken on diabetic patients aged between 19-79 years during the period of April 2004 to December 2004 in the Department of Pedodontics (Former Preventive and Children Dentistry) Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka and at Diabetic Clinic at Rajshahi district of Bangladesh. The study was conducted to evaluate how tobacco and betel nut along with other study parameters affect periodontal health in diabetics in the context of Bangladesh. The study population included 34 males and 47 females. Based on study results all study subjects brushed their teeth regularly and mostly with paste and brush. However, consistently the periodontal health in the middle sextants displayed better condition than the posterior sextants. From this view it can be presumed that in the middle sextants the pocket formation is not usually common may be because the anterior region (middle sextants) is easy to clean and have more opportunity to catch extra exposure to oxygen in comparison to posterior sextants. The present study also showed an interesting and controversial connection between periodontitis and tobacco and betel nut chewing among targeted diabetic patients. Though little is known about the effects of tobacco and betel nut among diabetics, it is almost well established that tobacco and betel nut are detrimental to oral health even if the individual is not diabetic. Nevertheless, a diabetic individual who use tobacco or chew betel nut or both is at much greater/higher risk factor for the edentulous mouth or in the mouth where less than two or three teeth are present but this study gives a contrast result regarding periodontal health. Present study detected that gum bleeding is totally absent among both the betel nut chewers as well as tobacco users and also they are not insulin dependent whereas most participants of this study who were neither tobacco users nor betel nut chewers were insulin dependent. In this regard, data of the current study indicate that tobacco and betel nut might be potentially helpful to control blood sugar among the diabetic cohort. It is perceived that the betel nut has an antibacterial property and so it can suppress the salivary organisms for prolonged betel nut users. In the ancients period, for treating bleeding gums in Indian medicine betel nut was also used. It might be possible that because of using tobacco blood circulation of gum may be hampered that eventually results in less or no gum bleeding. Therefore, it requires detecting the association between the higher periodontal index with the tobacco using and betel nut chewing habits. Since the sample size in this study was relatively small (81) and not representative, data have to be interpreted with care. Therefore, in order to validate these findings a longitudinal study could be a good option to elucidate this perception more concretely